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Abstract

Background: Placental growth factor (PlGF) and its endogenous inhibitor, soluble fms-like tyrosine kinase-1 (sFlt-1), play an important role in the pathophysiology of coronary artery disease. We recently demonstrated that plasma sFlt-1 level was negatively correlated with the severity of coronary atherosclerosis, and previous studies showed elevated PlGF level was a marker of poor prognosis in patients with acute coronary syndrome. In this study, we tried to examine whether plasma levels of PlGF and sFlt-1 predict the risk of long-term all-cause death (ACD) and total cardiovascular event (TCVE: ACD, nonfatal myocardial infarction, nonfatal stroke, CCU admission from CHF, introduction of maintenance hemodialysis) in patients with stable coronary artery disease (sCAD).

Methods: ACD and TCVE were investigated on June 2010 in 491 sCAD patients who received coronary angiography from February 2004 to December 2008. Median follow-up period was 3.3 years. Baseline blood samples were collected before coronary angiography (after 20-Unit heparin administration), and plasma levels of PlGF and sFlt-1 were measured using ELISA kits. Cox proportional hazard regression analysis was performed to evaluate the relationship between patients' parameters and events.

Conclusion: The present study demonstrated that baseline PlGF/sFlt1 ratio seems to be an independent predictor of adverse outcome in patients with sCAD in chronic phase, possibly due to the activated atherosclerotic process in patients with higher PlGF/sFlt1 ratio.